ICU Discharge, Depression, and Risk of Dying: New Study

Nicky Broyd

November 23, 2018

More than half of former ICU patients in the UK report symptoms of anxiety, post-traumatic stress disorder (PTSD) or depression, according to a new study published in the open access journal Critical Care. 

According to the new research, those reporting depression after surviving critical illnesses requiring care in an ICU appear to be at a greater risk of death.
 

Large Study

Researchers at the University of Oxford carried out a large multicentre investigation, Anxiety, Depression and Post Traumatic Stress Disorder after critical illness: a UK wide prospective cohort study, examining psychological disorders in 4943 former ICU patients.

Study participants had to be 16 years or older and have received at least 24 hours of level 3 ICU care in one of 26 ICUs in the UK between 2006 and 2013.

The patients who received treatment were asked to complete a postal questionnaire on their symptoms of anxiety, depression and PTSD 3 months after discharge from ICU and again 12 months after discharge.

Findings

The researchers found:

  • 46% of patients reported symptoms of anxiety

  • 40% reported symptoms of depression

  • 22% reported symptoms of PTSD

  • 18% of patients reported symptoms of all three psychological conditions

Corresponding author Dr Peter Watkinson said in a news release: "Psychological problems after being treated for a critical illness in the ICU are very common and often complex when they occur. When symptoms of one psychological disorder are present, there is a 65% chance they will co-occur with symptoms of another psychological disorder."

The researchers also found that patients with symptoms of depression were 47% more likely to die from any cause (all-cause mortality) during the first 2 years after discharge from the ICU than those without (HR 1.47, CI 1.19–1.80).

Dr Watkinson said: "Our findings suggest that depression following care of a critical illness in the ICU may be a marker of declining health and clinicians should consider this when following up with former ICU patients."

Study Limitations

The study authors say the main limitation of their postal survey is the relatively low response rate.

Plus they say the observational nature of the study and its reliance on self-reported data means it does not allow for conclusions about cause and effect between ICU care and symptoms of psychological disorders.

Also, they say the generalisability of the results outside of the UK may be limited as the data was only collected from UK based patients.

Critical Care. Nov 2018. Anxiety, Depression and Post Traumatic Stress Disorder after critical illness: a UK wide prospective cohort study. Abstract.

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